Challenging misleading healthcare claims

News

News items will be published here, but also sign up to our Newsletters — see the form on the right.

You can receive updates from the News feed, either to your RSS reader or via email.

NHS homeopathy in Scotland - on a shoogly peg

NHS Homeopathy in Scotland shows similar long-term decline to that in England

We've previously looked at how homeopathy in the English NHS has plummeted 95% in the last two decades. We now focus on what's been happening is Scotland.

The NHS in Scotland is separate from the NHS in England and they collate their prescription data separately, provided by the Information Services Division, a division of National Services Scotland, part of NHS Scotland. (Wales NHS and Health and Social Care in Northern Ireland are also separate and we may look at these in the future.)

Their Prescription Cost Analysis (PCA) data since 2001 (shortly after devolution in 1999) are available on one handy webpage, making them easier to find, with each spreadsheet covering the financial year from 01 April up to 31 March of the year given in the filename. The latest spreadsheet, PCA_2016.xlsx, therefore covers 01 April 2015 to 31 March 2016. Note that for consistency with the data for England, we have attributed the Scottish data for the year in the filename to the previous year in the charts below, ie the 2015/2016 data are attributed with 2015 to match the way the data for England have been attributed.

Tab 3 - BNF sub-section gives the data we need. As with the NHS Digital (the re-branded name for the HSCIC) data for England, the data relate to the NHS prescriptions dispensed in community pharmacies and by Dispensing Doctors in Scotland.

The prescription data are listed by BNF chapter, section and sub-section and the one for homeopathic (homoeopathic before 2013) preparations is 19.02.03. The data provided include the number of dispensed items, the Gross Ingredient Cost and the cost per item. Note that the costs given in the English data are called Net Ingredient Costs (NIC) but they are directly comparable: the Publication Report explains:

Comparability

The main measures of drug ingredient cost and volumes of items dispensed in the community are comparable across the UK countries. However it should be noted that the gross ingredient cost (GIC) within Scotland is equivalent to the net ingredient cost (NIC) in England, i.e. the reimbursement cost of drugs before any pharmacy discounts are applied.

Collating these data from each of the years gives the following:

The decline of NHS homeopathy Scotland

A spreadsheet with these data can be downloaded here.

Anomaly

But why the small rise in prescriptions in 2012 and 2013? Was there a resurgence in public demand for homeopathy? Perhaps more GPs became convinced of its curative power? Maybe some new, compelling evidence for homeopathy hit the headlines?

Probably not. The answer is more prosaic: the closure of the pharmacy at the Glasgow Homeopathic Hospital (re-branded the Centre for Integrative Care (CIC) recently) in 2011 will have caused a small increase in the number of prescriptions dispensed in community pharmacies.

When Andy Lewis revealed the closure of the pharmacy in November 2011, he said:

The ratchet on NHS homeopathy continues to turn. It would appear that the homeopathic pharmacy at the Glasgow Homeopathy Hospital has been closed.

A note to local GPs is reminding them that they have no obligation to fill the hole left by this closure by prescribing homeopathy if patients ask for it.

The Glasgow Local Medical Committee notes that there has been a sudden surge in requests from patients to prescribe homeopathic sugar pills after they have been unable to get them at the hospital.

The prescription numbers before 2011 don't include those dispensed at the GHH/CIC, but those after 2011 are inflated by the ones GHH/CIC patients have had go to their local community pharmacy to have dispensed.

But note that this blip is more than wiped out by the falls in 2014 and 2015, leaving an overall 62% drop in the past ten years.

The drop isn't as great as the 95% in England, but it is still very significant. Referrals to the GHH/CIC have been stopped by various Scottish Health Boards, putting pressure on them — it would seem unlikely that the long-term downward trend will be reversed.

Pressure

The number of patients at the GHH/CIC has been falling in recent years. Data from NHS Greater Glasgow and Clyde (GGC) — the health board that runs the GHH/CIC — show significant drops in the number of new inpatients from areas outside of GGCin recent years but that has been partially offset by an increase in numbers of referrals from within the GGC area. Overall, the number has still fallen 9% in the past four years to 332 in 2015 — about one new patient a day.

Similarly, falls in the number of new outpatients referred from areas outside GGC has been compensated by an increase in local referrals, leaving the number hovering around the 1,000 mark each year — in the order of three new patients a day. They also had 4,723 return appointments in 2015.

GHH admissions

The hospital is currently facing the closure by GGC of its seven inpatient beds (which had previously been cut in 2010 from 15 beds Monday to Sunday to seven beds Monday afternoon to Friday morning), saving £190,000, putting it under further pressure.

In their proposal to close the seven inpatient beds, they said:

The proposal to close the CIC beds is based on the fact that:

  • The Unit has reduced its inpatient service in recent years from a 15-bedded seven-day unit to only 7 beds, open 4 nights a week.
  • The Centre has been very successful in developing an ambulatory model of care and all services are now available on that basis.
  • Inpatient capacity is now underutilised delivering only 332 episodes of care each year. This will be further reduced by the continuing impact of decisions by other Boards to withdraw from the service, only 224 in patient episodes are provided for NHS GG and C residents.
  • Inpatients account for only 5.2% of patient contacts for GGC residents. The majority of service delivery is already delivered in an outpatient setting.

Supporters of the GHH/CIC are campaigning to prevent its closure, including a Public Petition to the Scottish Parliament: PE01568: Funding, access and promotion of the NHS Centre for Integrative Care. The committee has been considering this for well over a year and seem to be making little progress; instead they seem keen to show their inability to understand scientific evidence.

If the closure is agreed by the GGC Board, this makes the GHH/CIC even less viable and it's not clear how long the hospital can last — its future is on a shoogly peg.

England and Scotland

As a reminder, the charts for England:

The decline of NHS homeopathy England

Combining these (from 2001 to 2015) give the following for England and Scotland together:

The decline of NHS homeopathy England Scotland

Homeopathy has been diluted to just 13% of its former self in the past 14 years.

Out of proportion

Prescriptions: Scotland/EnglandBut looking at the data in more detail reveals something that looks odd: last year, there were 60% more prescriptions in total in Scotland than in England. The figures equate to 2.62 prescriptions per 1,000 population in Scotland but only 0.16 per 1,000 in England. But this has changed over the years: in 2001, it was the other way round with 2.7 times more prescriptions in England than in Scotland.

If it was simply down to population, you'd expect there to be more than ten times the number in England compared to Scotland.

Why is this not the case and why has it changed like this over the last 14 years?

One possible explanation might be to do with the number of NHS homeopathic 'hospitals' and the legitimacy they lend to homeopathy in general: there has only been the one in Scotland but there have been four in England in recent times: London, Bristol, Liverpool and Tunbridge Wells, plus a number of satellite clinics. Now, however, only the Royal London Hospital for Integrated Medicine remains, with the ones in both Liverpool and Bristol replaced by contracted private companies rather than being part of the NHS. The one in Tunbridge Wells closed in 2008. So, in its heyday around the turn of the century, Scotland was served by one but England was only served by four — proportionately far fewer considering the population.

So, with the only the London hospital now remaining — even though it no longer has a dedicated homeopathy service — the decline of prescriptions in England was perhaps inevitable, following the decline in the number of hospitals.

Good news

For those who do not believe public money should be spent on homeopathy, these figures will be welcome, but perhaps not so much for those in the homeopathy business as the false imprimatur given to homeopathy by the State plummets.

29 August 2016


Homeopathy on the NHS: at death's door

Homeopathy on the NHS falls for the eighteenth consecutive year

New figures released today show that homeopathy on the English NHS has fallen to a new low. The number of NHS prescriptions for homeopathy in England, fulfilled in community pharmacies, dropped by a further 13% in 2015 from the previous year and is 95% down from its peak nearly 20 years ago.

The data are compiled by the Health and Social Care Information Centre (HSCIC) — the official source of data for the NHS — and published as their Prescription Cost Analysis (PCA) data set.*

The new figures for 2015 show that there were just 8,894 prescriptions, down from 10,238 in 2014. The total cost of these prescriptions has dropped to £94,313, the first time it has been below £100,000.

The decline of homeopathy in the NHS 2015

The complete data for these charts are (all these figures can be verified from the original HSCIC data):

Year

Prescription

Items

Net Ingredient

Cost

Cost/item

1995

164,207

£816,798

£4.97

1996

172,013

£914,983

£5.32

1997

162,421

£937,311

£5.77

1998

157,063

£927,633

£5.91

1999

147,769

£888,274

£6.01

2000

134,164

£831,130

£6.19

2001

127,333

£807,125

£6.34

2002

117,989

£778,749

£6.60

2003

103,940

£714,938

£6.88

2004

94,501

£661,469

£7.00

2005

82,960

£593,316

£7.15

2006

62,679

£442,769

£7.06

2007

49,316

£321,418

£6.52

2008

26,337

£152,300

£5.78

2009

19,005

£100,486

£5.29

2010

16,359

£121,449

£7.42

2011

15,501

£130,601

£8.43

2012

15,262

£143,068

£9.37

2013

13,001

£137,298

£10.56

2014

10,238

£110,438

£10.79

2015  8,894  £94,313  £10.60

This follows on from other recent blows to NHS homeopathy: the closure of the homeopathy clinic at the South Bristol Community Hospital in Bristol, the reviews by both Liverpool CCG and Wirral CCG on ending the funding of homeopathy via the Liverpool Medical Homeopathy Service and other successfully completed reviews.

And the forthcoming Department of Health review of the blacklisting of homeopathy could mean CCGs are no longer able to prescribe it — not that many do now anyway.

Dilution by dilution, succussion by succussion, sugar pill by sugar pill, homeopathy is slowly but surely being removed from the NHS.

This will not be welcomed by homeopaths who businesses rely on the (undeserved and unearned) legitimacy that being provided on the NHS lends to homeopathy, but it's the inevitable result of the their own failure to provide robust evidence of its efficacy.

Switzerland legitimises homeopathy

In other news, however, it was announced by the international service of the Swiss Broadcasting Corporation, SwissInfo.ch, as:

Swiss to recognise homeopathy as legitimate medicine

…but it would have been more accurate to say:

Swiss to recognise homeopathy as if it were legitimate medicine

That's because:

…the interior ministry said it had come to the conclusion that it was “impossible to provide such proof for these disciplines in their entirety”.

So, it's not that the Swiss authorities had come across good evidence that homeopathy (and the other treatments covered) were, indeed, effective; more that they gave in and decided to reimburse them anyway, despite the lack of evidence.

The saga of homeopathy in Switzerland goes back many years (see That ‘neutral’ Swiss homeopathy report). Full and permanent inclusion in the Swiss state health reimbursement scheme from 2017 onwards was supposed to be contingent on being provided with evidence of "efficacy, cost-effectiveness and suitability" by 2015. Not surprisingly, homeopaths seem to have failed at that and the Swiss Government have completely ignored the findings of the comprehensive report by the Australian National Health and Medical Research Council that concluded:

Based on the assessment of the evidence of effectiveness of homeopathy, NHMRC concludes that there are no health conditions for which there is reliable evidence that homeopathy is effective. Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness. People who are considering whether to use homeopathy should first get advice from a registered health practitioner. Those who use homeopathy should tell their health practitioner and should keep taking any prescribed treatments.

It is therefore perverse that the Swiss Government should appear to bend over backwards to ignore the evidence and agree to pay homeopaths for dispensing their magic sugar pellets.

But it may not be as smooth a ride as the homeopaths might like. Reimbursement will only take place for treatments administered by certified medical doctors. Additionally, according to the official announcement in Komplementärmedizin soll anderen Fachrichtungen gleichgestellt werden, some criteria apply concerning tradition of usage and research, scientific evidence and medical experience and further education. Also, some treatments that are seen as critical are to be examined and potentially excluded from the reimbursement. It's not at all clear exactly what this will mean for the homeopaths, but this may not be the full endorsement from the Swiss Government they would like to believe.

Let's beware

This Sunday is the anniversary of the birth of the inventor of homeopathy, Samuel Hahnemann, heralding the start of World Homeopathy Awareness Week.

So as homeopathy on the NHS is in what must surely be its death throes, what better time to help others be aware of homeopathy?

Help spread the good news about homeopathy by sharing this newsletter and the following resources and further reading:

Discover Homeopathy

How does homeopathy work?

Homeopathy Awareness Week

Skeptic successes in homeopathy by Jo Brodie

NHS Homeopathy Legal Challenge by the Good Thinking Society

NHS Homeopathy Spending by the Good Thinking Society

Should Homeopathic Remedies Be Blacklisted On The NHS?&nbspby the Good Thinking Society

Follow us on Twitter and re-Tweet our Tweets on homeopathy throughout World Homeopathy Awareness Week.

Notes

* For details of how to extract the data on homeopathy from the (very large) HSCIC data set, see:  An idiot’s guide to understanding NHS homeopathy prescription data

07 April 2016


Rubbing salts into the wounds of homeopathy

Homeopathy has suffered many body blows recently. A new decision by the medicines regulator rubs salt into its wounds.

The last year or so has not been good for homeopathy. The comprehensive Australian National Health and Medical Research Council concluded that "there are no health conditions for which there is reliable evidence that homeopathy is effective." The FDA and the FTC in the US are considering their positions on the regulation and advertising of homeopathic products and will hopefully clamp down on the worst excesses of misleading claims made there. In the UK, homeopathy continues its downward spiral, it's being challenged in Liverpool and the Department of Health will consult next year of the complete blacklisting of homeopathy. 2016 is going to be a very interesting year for homeopathy.

Last August, we published details of our complaints against Nelsons Homeopathic Pharmacy. We're still waiting for the General Pharmaceutical Council to complete their investigation, but the medicines regulator, the MHRA, has already published their decision. In that newsletter, we said we were waiting for a further response from the MHRA. Although we're still waiting for a formal reply from them, the essence of what we were waiting for has just been published by them in yet another complaint about homeopathic products.

Schuessler Salts

Wilhelm Heinrich Schüßler (Schuessler) was a German medical doctor and naturopath. He concocted twelve biochemic 'cell salts' or 'tissue salts' (as he called them), intended to redress percieved bodily deficiencies in one mineral or another. Frequently referred to as 'microdoses' these are accepted as homeopathic by some homeopaths and rejected by others. When I asked one manufacturer, I was told:

Tissue Salts are not homeopathic but are homeopathically prepared micro dose minerals. Dr. Schuessler believed that it was most effective to follow the principles of homeopathy in their preparation – 1 part mineral to 9 parts lactose – mortar and pestle for 20 minutes bringing it up to a 1X and so on.  They can be touched by hand and work differently in the body navigating all that you eat and ingest where they need to be.  They are not as sensitive as homeopathics.  They can be taken alongside food, coffee etc.

And:

Tissue Salts are not Homeopathics but are micro dose minerals that follow the similar method used in preparation - they will not interfere with homeopathic Nat Mur - it is important to note that Minerals are not homeopathic, they are biochemic. They do not follow the rule of similarity as many consider but are prepared in the homeopathic manner in order to provide bioavailability. The system needs minerals in order to function in these minute doses. They are absorbed through the mucosa that enables them direct entry to the blood stream and the availability to the cells.

At least that's clear…

Whatever the different factions within homeopathy believe, Schuessler Salts are frequently labelled and sold as being homeopathic. But are they as ineffective as homeopathy? The Commissioner for Public Health in Australia looked into one of these salts and declared:

Schuessler noticeTHE following report is issued under section 210 of the Health Act, 1911-1944:—It is claimed that the above "remedy" [Dr. Schuessler's Cell Salts, Kali Phos. 3X] is "indicated in loss of mental power, brain fag, paralysis of any part, nervous headaches, neuralgic pains, general disability and exhaustion and sleeplessness from nervous disorders." The "remedy" has been analysed and been found to contain potassium dihydrogen phosphate and lactose. The actual quantity of potassium dihydrogen phosphate in the "adult dose" is so minute that over 9,000 tablets would be necessary to give the minimum medicinal dose of this drug. Lactose is a sugar which is of no value in the treatment of any of the above-mentioned maladies. Dr. Schuessler's Cell Salts can therefore have no curative value. They will bring about no improvement in any of the illnesses for which they are said to be indicated. Any expenditure on the purchase of these salts will be money wasted.
— C. E. COOK, Commissioner of Public Health

That was in 1946.

One of the main brands of these products is an Australian company, Martin & Pleasance, but there are others, including the New Era range (once owned by the pharmaceutical giant, Merck through their Seven Seas brand, but now owned by the Italian company, Olimed Ltd, sold in the UK by Power Health Products Limited).

Nelsons

It was the Martin & Pleasance products we found being advertised on Nelson's website. Because they do not have a licence under the National Rules Scheme, an authorisation under the Homeopathic Rules Scheme nor even a (defunct) Product Licence of Right, we questioned whether these could be unlicensed medicines. The significance is that if the MHRA ruled they were unlicensed medicines, it would be a breach of the Human Medicines Regulations 2012 (HMR 2012) to advertise, supply or sell them.

Kali Mur 6XToday, the MHRA published their decision on a complaint about the advertising of these or similar products by Homeopathy Express, Nutricentre and Health Stuff. Although these were not our complaints, the MHRA have now published what they told us previously about Schuessler products and what we've been trying to get them to state publicly:

MHRA guidance: Tissue Salts/Schuessler Salts are considered to be medicinal products if any of the following appear in promotional material:
  • the terms ‘homeopathic remedy’, and/or ‘homeopathy’ and/or ‘homeopathically prepared’
  • a numerical value for the potency eg 6X and/or the word ‘potency’ itself
  • indications for use in a medical condition
All other cases will be reviewed on a case-by-case basis.

So, it's perfectly OK to advertise these products as long as it is not claimed that they are in any way homeopathic, they do not have a homeopathic 'potency' and they have no therapeutic indications. If they comply with all of these restrictions, they will not be medicines, but will simply be food supplements and have to comply with food regulations. This is essentially the same as when Bach Flower products were declared to be foods, not medicines nearly a year ago.

The standard labelling of these products (such as the one in the photograph) stated they were '6X' 'potency' and the mere mention of this is sufficient to bring it within the MHRA's definition of a homeopathic medicine. This is a direct consequence of the EU Directives and the HMR 2012: homeopathic 'medicines' are regulated and anything that is presented as being homeopathic is a medicine and has to comply with these rules.

If they are not presented in any way as homeopathic, then they are just foods, not medicines.

MHRA Schuessler Salts decisionQuite rightly, the MHRA will review each product individually, but we think it's clear that this ruling applies to the following:

There may be others and if you spot any on sale in the UK that appear to be contravening the MHRA's new guidance, please let us know and consider submitting a complaint to the MHRA about them.

The aftermath

Before our complaint against Nelsons, their website said:

Nelsons Schuessler

That page now says:

Nelsons Schuessler 2

There is now no mention that these products are homeopathic.

But what about the websites of the three sellers mentioned in the MHRA's decision?

Homeopathy Express

This is advertising New Era Calc Sulph (No.3) Tissue Salts and Brittle Nails & Falling Hair (Comb - K), but both are currently not available and another page says they have been discontinued. It looks like they also used to sell the Dr Reckeweg brand of tissue salts but they have been removed.

Health Stuff

Whatever Schuessler/cell/tissue salt products they sold, they are no longer advertised on their website.

Nutricentre

Thirteen of the sixteen Schuessler products they advertise are currently out of stock.

For two of the three that are available, the description shows:

Combination J:

Congestion by Schuessler Tissue Salts. Kali Mur Nat Mur & Ferr Phos For relief from symptoms associated with Chest congestion Coughs Colds Available in tablets. Always read the label use only as directed. If symptoms persist consult your healthcare professional. For over 150...

Combination H:

Schuessler Combination H Tissue Salt is a complete natural formula for hayfever and allied conditions with mag phos nat mur and silica. Hayfever is an allergic condition of the mucous membranes of the nose eyes and upper respiratory tract and is common during spring when sensitivity to pollen is severe but it is very treatable by combination H particularly if treatment is started from six weeks before the expected onset of normal symptoms.

For Calc Fluor No 1, although out of stock, the product page states:

The cell salt Calcium fluoride is primarily a salt of the connective tissue

Also the bones and parts of the skin and blood vessels belong to the connective which is why Calcium fluoride can be used for all problems of these tissues

Ingredients: Calcium Fluoride 6X Lactose Monohydrate Calcium Hydrogen Phosphate Magnesium Stearate

Many of the others have similar information.

These would appear to be therapeutic indications and some refer to the potency as 6X, possibly contravening the MHRA's guidance so we'll be bringing these to their attention and hope that they will be corrected before the products return to stock.

This is another step forward for informed consumer choice, but another blow for homeopathy. Gradually, sellers of homeopathy and homeopathy products are being held to account. Homeopathy is taking a beating, perhaps fatally wounded.

Addendum

I have just come across this advert for New Era Tissue-Cell Salts in the February 1951 issue of the homeopathy magazine, Heal Thyself:

New Era Heal Thyself February 1951

It's a pity the Advertising Standards Authority wasn't around then.

30 December 2015


On a downward spiral

The defunct Tunbridge Wells Homeopathic Hospital

Not that long ago there were five homeopathic hospitals in the UK: London, Tunbridge Wells, Bristol, Liverpool and Glasgow. The Tunbridge Wells and Liverpool hospitals have since closed and the pharmacy at the Glasgow one is no more.

As for the Bristol hospital, it started out in its own building near the centre of Bristol (Cotham Hill), then it became a small clinic in the new South Bristol Community Hospital. Earlier this month, just three years later, this too closed to be replaced by a private clinic, the Portland Centre for Integrative Medicine, that is no longer part of the NHS but that is now just contracted to provide homeopathy services to University Hospitals Bristol. It's situated in Litfield House Medical Centre, which offers private consulting rooms, some six miles from the hospital.

And then there were two

Today, there remains only the Royal London Hospital for Integrated Medicine (the re-named Royal London Homeopathic Hospital) and the Glasgow Homeopathic Hospital (aka the Centre for Integrated Care, as they like to call it).

NHS Lanarkshire was the latest of the Scottish health boards to end funding of all treatments at the Glasgow Homeopathic Hospital, and, in August, one of it's previous patients from Lothian lost her judicial review at the Court of Session of the earlier decision by NHS Lothian, finally putting an end to the homeopathy supporters' protracted battle.

But now we know that even the jewel in the homeopaths' crown, the RLHIM, no longer has a homeopathy service.

We've known this for some time as it was admitted by them in their response to a Freedom of Information Act request last year and this service has not been mentioned on their website for some time. It is now public thanks to someone else's FOIA request. All they provide now are:

  • Acupuncture Services
  • Adult Allergy Service
  • Allergy Service
  • Chronic Fatigue Service
  • Children’s Service
  • Complementary Cancer Care Service
  • Fibromyalgia Syndrome Service
  • General Medicine Service
  • Hypnosis Service
  • Insomnia Service
  • Irritable Bowel Syndrome Service
  • Musculoskeletal Medicine Service
  • Nutrition and Dietetics
  • Podiatry Service
  • Rheumatology Service
  • Skin Service
  • Psychological Services
  • Weight Loss Service
  • Women’s Service

But no homeopathy service. For their flagship hospital, closing that down must have been a bitter sugar pill to swallow.

Even though homeopathy isn't mentioned they still provide it under the guise of other services. The list of services doesn't match those listed on their website (and there are some interesting differences), but some do include homeopathy:

Of course, we've won several Advertising Standards Authority rulings and informally resolved cases against the RLHIM over claims they made on their website and in leaflets. In Homeopathy clinic toes the line, we briefly mentioned Prof David Colquhoun's blog post: Conflicts of interest at the Homeopathic Hospital. It's good to see that the RLHIM has since made this clearer:

Marigold COI

And in overall terms, we also already know that the number of prescriptions for homeopathy products supplied by community pharmacies in England has fallen by 94% in the past 17 years.

The decline of homeopathy in the NHS number of prescription items 2014

We also know that very few Clinical Commissioning Groups fund homeopathy.

How much longer will NHS homeopathy survive this downward spiral?

Ainsworths

After Nelsons were reprimanded in August (as a result of our complaint), another homeopathy manufacturer was today admonished by the medicines regulator, the MHRA.

Ainsworths MHRA

As part of MHRA’s regular review of advertising, we reviewed the Ainsworths website. Some unlicensed homeopathic remedies had the name of a commonly recognised disease or medicine. We were concerned that this could be seen as a claim to treat or prevent that disease. We were also concerned that remedy kits containing unlicensed remedies were being promoted for sale in the UK.

Ainsworths agreed to remove the name of the disease and the medicine names from unlicensed remedies on their price list and amend the web pages with remedy kits.

It's encouraging to see that the MHRA instigated this themselves rather then waiting for a complaint from a member of the public or a pharmacist, but it's disappointing that they have not given details of what products they were concerned about.

In terms of the kits, they have been in trouble before, so it's disappointing to see them being pulled up again, apparently for exactly the same breach of the medicines regulations.

Note that the decision is dated 10 June, yet the decision was only published today. It's therefore even more disappointing and concerning to see Ainsworths still advertising unlicensed remedies such as these:

Ainsworths products

We sincerely hope that Ainsworths will comply with the MHRA's instructions to remove all products with the name of a commonly recognised disease or medicine, and — in the interests of not misleading the public — products that have names very similar to commonly recognised diseases or medicines. We're sure Ainsworths would not want to mislead consumers but we hope the MHRA will continue to monitor their website and take further action as necessary to protect consumers.

 

 

Photo credit

The defunct Tunbridge Wells Homeopathic Hospital by Tannice Hemming.

22 October 2015


Nelsons Homeopathic Pharmacy #1

The medicines regulator, the Medicines and Healthcare products Regulatory Agency (MHRA) have today published their decision on a complaint we made to them a few months ago about the homeopathy manufacturer and seller Nelsons Homeopathic Pharmacy.

As usual, the MHRA give few details of the complaint, their investigation, what they found or what they decided:

MHRA Nelsons decision 14 August 2015

Even though there is a link that purports to give more information, this simply links to the page where this decision is listed along with others for July. They even fail to give the proper name for the trader, Nelsons Homeopathic Pharmacy, or give the urls of the two websites involved: http://www.nelsonsnaturalworld.com and http://www.nelsonspharmacy.com/.

It's not clear to us why these decision notices are so void of any details that would help consumers: the Advertising Standards Authority (ASA) by contrast, when they publish an adjudication, give full details of the complaint, their investigation, the advertiser's response, their decision and the sanctions applied. For example see this ASA adjudication against another homeopathy manufacturer, Ainsworths.

The issues we highlighted to the MHRA were mostly about the advertising of homeopathic products that was not within the terms of the authorisation or registration for those products. For example, their Arnicare Arnica 6C product stated:

Indications: For the symptomatic relief of sprains, muscle aches, bruising and swelling after contusions.

However, this is a Homeopathic Rules (HR) scheme product and its registration does not permit therapeutic indications. Instead, all advertising for HR products must simply contain the text:

A homeopathic medicinal product without approved therapeutic indications.

It's a moot point whether the general public understands this to mean that there is not a jot of good evidence that these products have any therapeutic effects whatsoever, a point raised by the House of Commons Science and Technology Select Committee in their Evidence Check on homeopathy.

Another page advertising their Aconite 30C National Rules (NR) scheme product contained the following instructions:

They can even be dissolved in warm water if preferred.

However, the Public Assessment Report for ths product gives the posology and method of administration as:

Adults and children: Take 2 pillules every 2 hours for the first 6 doses, then 4 times daily until symptoms improve for up to a maximum of 7 days.

Pillules should either be chewed or placed under the tongue until dissolved.

Although it makes not the slightest difference to the 'effectiveness' of the homeopathic product, there is no mention of dissolving in warm water as a permitted method of administration.

The other issues covered by this decision were similar to these and we suspect they were simply oversights by Nelsons — they have now corrected them.

In total we identified eight issues with the advertising of their products on their websites, including the ones above. When the MHRA told us of their decision, we queried a couple of points and we're waiting for a further response from them. We'll let you know when these have been satisfactorily resolved.

However, the issues the MHRA have dealt with were just part of our larger complaint to both the MHRA and the General Pharmaceutical Council (GPhC), the statutory regulator for pharmacies and pharmacists. Once the GPhC have completed their investigations into all the other issues we raised, we'll let you know.

Meantime, we've added this MHRA decision to our growing list of published results.

14 August 2015

Stemming the tide

The list of misleading adverts in the magazine What Doctors Don't Tell You sometimes seems endless, 

Life Long ProductsThe April 2015 issue of What Doctors Don’t Tell You carried an advert by Life Long Products for their 'Stem Cell Therapy (SE2)' product that claimed it could improve the body's ability to:

  • MAINTAIN optimal health
  • BOOST your immune system
  • PROTECT your nervous system

We know that boosting the immune system is a common claim made by advertisers of alternative therapies and supplements and something they might like us all to think is good for us. In fact, it turns out that boosting the immune system is not such a good idea at all.

The testimonial in the advert could also give the impression that arthritis sufferers using this product can stop using painkillers.

As has been noted elsewhere, there is frequently a connection between adverts and articles, and this one boasts:

StemTech as featured in WDDTY Jan & March Issues - by Vet Paul Boland

Can stem cell therapy provide these benefits? The product page on the advertiser's website states:

Stemtech’s SE2® is the world’s first all-natural supplement documented to support the release of adult stem cells from bone marrow. Our advanced supplement puts more stem cells in the bloodstream, and the effect lasts longer.

An advancement in Cellular Renewal – helping Nature do what it is designed to do

This 'advanced supplement' doesn't come cheap, of course: a bottle of 60 capsules costs £60.95 (plus shipping), but it might seem a bargain if the claims stood up to scrutiny.

But this product isn't regulated by the Human Fertilisation and Embryology Authority or even the Medicine and Healthcare products Regulatory Agency (MHRA): it isn't stem cell therapy derived from bone marrow, umbilical cord blood, etc, but simply a food supplement.

As a food supplement, the only claims permitted in advertising are those listed on the EU Register of nutrition and health claims and in the UK, those advertising claims are regulated by the Advertising Standards Authority (ASA).

Because we didn't believe the claims being made were authorised claims, we submitted a complaint to the ASA.

While we were at it, we looked further at the advertiser's website and included complaints about some of their other products: Jamu (cached), Forever Freedom® Aloe Vera Juice (cached), Serrapeptase (SerraEnzyme)- High Potency Capsules (cached) and PainSolv MkV Class IIa Medical Device (cached).

The page for the Jamu product no longer exists and the advertiser appears to have completely removed it from their website, but they had claimed:

Jamu (formerly Djamu) is traditional medicine in Indonesia. It is predominantly herbal medicine made from natural materials, such as parts of plants such as roots, bark, flowers, seeds, leaves and fruits. Materials acquired from animals, such as honey, milk, Ayam Kampung eggs and goat’s bile, are also often used.

…and they listed more than a dozen products in the range with descriptions such as 'Cholesterol Control', 'Naturally Lowers Blood Pressure', 'Naturally Dissolves Kidney Stones' and 'Naturally Reduces Blood Glucose Levels'.

ASA investigation

The ASA originally said they would contact Life Long Products and ask for their comments on several points they identified in the website advert for PainSolv references to pain reduction and management; some of the claims were made in a video on their website, but which is also within the ASA's remit. The advertiser could then provide the required evidence to substantiate the claims or agree with the ASA to remove the claims.

For the other points of the complaint about the supplements and Jamu herbal product, the ASA said those were sufficiently straightforward and would take them up informally with the advertiser, asking them to:

…remove the health and disease claims from their Stem Cell Therapy, Aloe Vera and Serrapeptase, and to remove the Jamu products from their marketing activity.

Although not stated, we believe the Jamu products were unlicensed medicines that would be a breach of the Human Medicines Regulations 2012 to advertise, supply or sell to the public and we're pleased to see that there is now no reference to these products on the advertiser's website.

Serrapeptase has, of course, been the subject of a previous complaint of ours against an advertiser in What Doctors Don't Tell You. That time, the ASA adjudicated on the evidence Good Health Naturally provided but ruled it was not adequate to substantiate the claims made. They upheld our complaint on all four points, identifying eight breaches of their CAP Code.

However, instead of providing evidence to substantiate their claims for PainSolv, the ASA notified us that the advertiser had agreed to:

…implement suitable changes to their website to bring it in line with the CAP Code.

So, instead of an adjudication, the ASA have today published the outcome of our complaint as an informally resolved case.

Except...

Except… although the advertiser has removed all mention of their Jamu products from their website, we see no other changes as yet.

If those pages don't change soon, we'll bring them to the attention of the ASA.

HealthWatch UK

HealthWatch logoThe charity HealthWatch (not to be confused with the recent NHS organisation "Healthwatch England") has a study under way to test the effectiveness of consumer protection laws against misleading health claims.

A previous study by HealthWatch, Spurious Claims for Health-care Products: An Experimental Approach to Evaluating Current UK Legislation and its Implementation found some worrying results showing widespread variation in the application of consumer protection law and a reluctance to enforce it to protect consumers. Now is the time to build on that research with this bigger study.

 

Useful data are coming in, but more volunteers are urgently needed.

The study comprises these steps:

  1. Request traders for evidence to support claims made on their websites. You will be provided with trader details, 5 for each volunteer.
  2. Ask traders to stop making false claims.
  3. Complain to Trading Standards, via the Consumer Direct website.
  4. Follow up each complaint for six months.

All data are captured in a suite of online forms, and results will be submitted to a major journal.

If you are interested, please contact HealthWatch trustee Les Rose. Although it's not at all labour-intensive (so the current team reports), please only volunteer if you have the time.

12 August 2015


 

Gravityscan Badge

Newsletter

To subscribe to our Newsletter, enter your details below and click Subscribe.
You will receive a confirmation email. Please click on the link in the email to confirm your subscription.